Cervicogenic headache is a secondary type of headache resulting from dysfunction in the neck region. Currently, the prevailing theory in research on how this form of headache occurs is that mechanical problems—such as sprains or strains, disc herniations, or degenerative arthritis—irritate one or more of the upper cervical spinal nerves (typically C1–C3), and this irritation can cause referred pain that is perceived in the occipital (back of head), frontal (forehead), temporal (sides), or orbital (eye) regions. It is estimated that cervicogenic headaches account for approximately 4% of all headache cases and represent a common reason why adults, particularly those approaching middle age, seek chiropractic care.

When patients present to a chiropractic clinic with headaches, chiropractors will rely on patient history, clinical examination findings, and provocative orthopedic tests to determine if the headache is cervicogenic or another type (such as migraine or tension-type). Diagnosis can be complicated because some patients experience multiple headache types simultaneously.

To accurately diagnose cervicogenic headaches, chiropractors specifically look for these hallmark characteristics: unilateral pain (on one side of the head only) that does not shift sides in subsequent episodes; pain that typically originates in the neck and then radiates upward to the occipital, temporal, frontal, or orbital areas; pain that’s described as non-throbbing and non-lancinating (steady, dull, or aching rather than sharp or pulsing); episodes that vary significantly in duration, from hours to days, or even months; headache pain that’s frequently triggered or aggravated by neck movements or applying external pressure to the cervico-occipital junction (base of skull and upper neck); and pain that’s commonly accompanied by restricted neck range of motion and vague pain or stiffness in the shoulder or upper trapezius area.

Once the diagnosis is confirmed and underlying musculoskeletal dysfunction is identified, treatment can commence. Chiropractors typically employ a multimodal approach, combining in-office manual therapies (such as spinal adjustments, mobilizations, soft-tissue therapies, and muscle-energy techniques) with targeted therapeutic exercises for the patient to perform at home. Treatment for cervicogenic headache may also include intermittent cervical traction, administered either in-office or with an at-home traction device. Cervical traction helps relieve nerve root irritation or compression, decrease muscle spasms, enhance joint mobility, reduce vascular constriction, and promote healthier postural alignment.

Standard treatment guidelines for cervicogenic headaches often recommend an initial course of approximately eight to ten chiropractic visits over four to six weeks. However, exact treatment frequency and duration may vary based on individual patient factors and the chiropractor’s clinical judgment.